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medpundit |
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Wednesday, May 28, 2003Public health officials are still trying to determine the origins of the latest SARS outbreak. They still do not know where the index patient - the first patient during this second outbreak - contracted SARS. That was a 96-year-old man who was in North York General for a pelvic operation. He started showing symptoms of SARS on April 19, but his case went diagnosed as post-operative pneumonia, said Low. The man died on May 1. Health officials became aware of this secondary outbreak after a patient with a compromised immune system was transferred to the Toronto General Hospital from St. John's. That patient arrived at St. John's on April 28 with no SARS symptoms and became sick after the transfer. Officials knew they had another potential SARS outbreak when health care workers started coming down with symptoms. There would have been no reason to suspect SARS in a 96 year old man who had a pelvic operation. It doesn’t say what sort of pelvic operation it was - it could have been a hip fracture repair or a prostate surgery - but surgery in a 96 year old is inherently risky. It isn’t uncommon for someone that age to develop acute respiratory distress syndrome in response to the stress of surgery, which is very similar to SARS clinically except that it isn’t infectious, or to develop pneumonia afterwards. No one would have suspected SARS under those circumstances. But Simmins makes a good point - strict use of respiratory precautions are essential to stopping the disease’s spread. Which makes me wonder if perhaps we shouldn’t be more aggressive with these than we currently are. A patient admitted with community aquired pneumonia wouldn’t be placed in respiratory isolation in most U.S. hospitals. But maybe they should be given the sneakiness of SARS. Then again, there’s the report of healthcare workers who got SARS even though they protected themselves, which reminds us that even careful precautions aren’t perfect. Still, quite a few of them came down with the illness, while in the U.S. there have been no cases of healthcare workers falling ill. It could be that the equipment we use is better. Or, it could be that the Canadian healthcare workers in the report weren’t being entirely truthful about their use of masks, goggles, and gloves for fear of repercussions. Quite honestly, sometimes doctors and nurses forget to protect themselves, especially in unexpected emergency situations (say, a person found suddenly unresponsive or in severe respiratory distress). But in the age of SARS, it's probably better to treat every hospitalized respiratory infection as potentially highly contagious until proven otherwise. posted by Sydney on 5/28/2003 08:23:00 AM 0 comments 0 Comments: |
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